1608 LOT NO. 1 I�
NO. STREET
FOR APPLIANCE PERMIT
CITY OF CUPERTINO
1$ JAN I
I 1964 � a
Date , 19(1.1 /. Permit No. /
CITY OF CUPERT'^ " FeetrU.
Application is hereby made to the City of Cupertino for a permit to install
gas appliances as listed on the reverse side hereof, and agrees to install said
appliances in accordance with the provisions of the Plumbing rode of the City
of Cupertino, and all lother laws applicable thereto.
Use of Premises
U
T Owner Addre
B Address — 5
CONTRACTOR, AGAkr
Phone Approve
PLUMBING INSPECTOR
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TIONA. 7CHARGE
APR2 1c�rY� �IcuPFRTINo_ :.
Cl-
n BUILDING INSPECTOR'S OFFICE
Date ... ....C.l-*- [ -CUPER"f"TUNO64.. .. Permit No. ._16�8
To .... ---Ventilatir Co..--------------------..., ----..---
Address,:-1b7v0--Nv' --$laney,---GreEnW00d---Gt- Apt" B3:"'' 4:
_ Reason''-$1,50 .:charge_oer-_unit--__(2 . ton) foi�;:appl]:anee;
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pv.Mit e fefor 'Air Conditioners. .( 4 Unita Per
.:bu! ding) - G , •l f v�tfi� �.�
�Am 3/59S3nn 6.�0' Signed ........... .. .---- ` t f